比伐卢定在高龄急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗中的疗效观察

姜阳; 郑晓群; 林海龙

doi:10.13201/j.issn.1001-1439.2017.05.006

比伐卢定在高龄急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗中的疗效观察

- 1. 大连市中心医院心内四科(辽宁大连, 116033);
- 2. 大连市中心医院心内一科

详细信息

通讯作者: 林海龙,E-mail:linhailong@medmail.com.cn

中图分类号: R541.4

收稿日期: 2016-10-14

修回日期: 2017-03-12

Effects of bivalirudin on primary percutaneous coronary intervention in elderly patients with acute ST-elevation myocardial infraction

- Department of Cardiology, Dalian Municipal Central Hospital, Dalian, Liaoning, 116000, China

More Information

Corresponding author: LIN Hailong, E-mail: linhailong@medmail.com.cn

Received Date: 14 October 2016

Revised Date: 12 March 2017

摘要

摘要: 目的：观察在年龄>70岁的急性ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入治疗（PCI）术中应用比伐卢定抗凝的安全性及疗效。方法：采用回顾性病例对照研究，收集2016-01-2017-01因急性STEMI就诊于我院并行急诊PCI术且年龄>70岁的患者共136例，根据术中基础抗凝药物的应用分为两组：比伐卢定组66例及普通肝素组70例。主要观察住院期间及术后30 d内的出血及主要心血管不良事件（MACE）。结果：两组患者在年龄、性别、高血压、糖尿病、术中联合使用血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂（GPI）等方面无统计学差异。普通肝素组患者术后依诺肝素和磺达肝癸钠使用概率明显大于比伐卢定组（P<0.05）。与普通肝素组比较，比伐卢定组术后30 d内总体出血事件发生率（5.7%：3.0%）、支架内血栓事件发生率（1.4%：0）及MACE发生率（8.6%：3.0%）均有降低，但两组差异无统计学意义。结论：高龄急性STEMI患者急诊PCI术中抗凝治疗应用比伐卢定与普通肝素相比，出血及MACE事件发生率无明显差异，比伐卢定抗凝治疗安全有效。
- 比伐芦定 /
- 肝素 /
- ST段抬高型心肌梗死 /
- 经皮冠状动脉介入治疗
Abstract: Objective: To observe the efficacy and safety of bivalirudin on primary percutaneous coronary intervention (PCI) in elderly patients older than 70 years of age with acute ST-elevation myocardial infarction (STEMI). Method: A total of 136 patients older than 70 years of age with acute STEMI undergoing emergent PCI from Jan 2016 to Jan 2017 were collected. According to the anticoagulant during procedural, the patients were divided into two groups:bivalirudin group (n=66) and heparin group (n=70). 30-day post-operative bleeding and the occurrence rate of major adverse cardiac events (MACE) were observed. Result: There was no significant difference in age, gender, hypertention, diabetes mellitus, GPⅡb/Ⅲa used during perioperation of PCI between the two groups. Enoxaparin and fondaparinux sodium were used post PCI more in heprin group than those in bivalirudin group (both P<0.05). Compared with heprin group, the rates of 30-day post-operative bleeding (5.7% vs. 3.0%), in-stent thrombosis (1.4% vs. 0) and occurrence of MACEs (8.6% vs. 3.0%) were decreased in bivalirudin group, but the above differences were not satistically significant. Conclusion: During perioperation of PCI in patients order than 70 years of age with acute STEMI, there is no significant difference in the occurrence rate of bleeding and MACEs between bivalirudin and heparin, bivalirudin is efficient and safe.
- bivalirudin /
- heparin /
- ST-elevation myocardial infarction /
- percutaneous coronary intervention

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参考文献(11)

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